Therapeutic interventions for Burkitt's lymphoma in children

Burkitt's lymphoma (BL) is a small non-cleaved cell lymphoma which commonly presents as jaw swellings. Uncertainty remains as to the most effective form of management.

To assess the evidence of any therapeutic strategy in the treatment of BL.

We searched MEDLINE (1966-March 2006), LILACS (1982-March 2006), EMBASE (1974-March 2006) and the Cochrane Controlled Trials Register (all years, latest Issue 01/2006) to identify relevant trials. All of these references were accessed in order to identify additional trials in BL.

Randomised controlled trials (RCTs) of any duration were included. We included studies conducted in children with a confirmed diagnosis of BL. Studies were not restricted by geographical location or by language of publication. Any therapeutic intervention was considered. The primary outcome was overall survival.

Two reviewers assessed studies for relevance. Studies that met the entry criteria were assessed for study quality. Data were extracted independently and were entered into RevMan 4.2.

Twelve studies met the entry criteria of the review but data could only be retrieved from ten. Inadequate reporting of study methodology was a common feature of the trials preventing thorough assessment of study quality. We were unable to pool data for any of the outcomes due to the differences between the interventions assessed in the studies. Seven studies aimed to induce remission: Overall survival did not differ significantly between treatment groups in three out of four studies reporting this outcome. Five studies aimed to maintain remission: In two out of three studies reporting survival, it was substantially, but not statistically significantly, different between treatment groups.

This review does not currently provide any strong evidence on the relative effectiveness of interventions to treat Burkitt's lymphoma. The studies that have been conducted to date are small, underpowered and prone to both systematic and random error.